중심정맥도관관련 혈류감염의 신속한 진단을 위한 실시간 다중핵산증폭검사의 유용성 평가
Clinical Efficacy Evaluation of Multi-parameter Realtime Polymerase Chain Reaction for the Central Venous Catheter-related Blood Stream Infection
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Background: The study evaluated the clinical efficacy of a multi-parameter realtime polymerase chain reaction (PCR) test for patients with central venous catheterrelated bloodstream infection (CRBSI). Materials and Methods: Thirty five patients suspected to have CRBSI were enrolled. The SeptiFast™ (SF) multi-parameter real-time PCR test (Roche Diagnostics, Germany) and blood culture were performed and results were compared. Results: The turn-around time for the SF test and blood culture was 32.6±28.9 hours and 115.8±23.5 hours, respectively. Among the 70 blood samples, the positive rates of SF test and blood culture were 34.3% and 27.1%, respectively, and the agreement rate was 62.9%. Gram-positive bacteria were detected in 10 patients with blood culture and 11 patients with SF test. Gram-negative bacteria were detected in one patient with a blood culture and in seven patients with SF test. Candida was not detected in blood culture but was detected in two patients by the SF test. Conclusions: SF test was faster and more sensitive for the detection of blood pathogens than blood culture. It provides a more sensitive detection of gramnegative and Candida in blood than does blood culture testing.
Abstract
Background: The study evaluated the clinical efficacy of a multi-parameter realtime polymerase chain reaction (PCR) test for patients with central venous catheterrelated bloodstream infection (CRBSI). Materials and Methods: Thirty five patients suspected to have CRBSI were enrolled. The SeptiFast™ (SF) multi-parameter real-time PCR test (Roche Diagnostics, Germany) and blood culture were performed and results were compared. Results: The turn-around time for the SF test and blood culture was 32.6±28.9 hours and 115.8±23.5 hours, respectively. Among the 70 blood samples, the positive rates of SF test and blood culture were 34.3% and 27.1%, respectively, and the agreement rate was 62.9%. Gram-positive bacteria were detected in 10 patients with blood culture and 11 patients with SF test. Gram-negative bacteria were detected in one patient with a blood culture and in seven patients with SF test. Candida was not detected in blood culture but was detected in two patients by the SF test. Conclusions: SF test was faster and more sensitive for the detection of blood pathogens than blood culture. It provides a more sensitive detection of gramnegative and Candida in blood than does blood culture testing.
참고문헌 (17)
- Angus DC, "Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care", Crit Care Med, 29, pp.1303~1310 (2001)
- Richards MJ, "Nosocomial infections in medical intensive care units in the United States. National Nosocomial Infections Surveillance System", Crit Care Med, 27, pp.887~892 (1999)
- Maki DG, "The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies", Mayo Clin Proc, 81, pp.1159~1171 (2006)
- Dimopoulos G, "Approach to the febrile patient in the ICU", Infect Dis Clin North Am, 23, pp.471~484 (2009)
- McGee DC, "Preventing complications of central venous catheterization", N Engl J Med, 348, pp.1123~1133 (2003)
- Pittet D, "Nosocomial bloodstream infection in critically ill patients. Excess length of stay, extra costs, and attributable mortality", JAMA, 271, pp.1598~1601 (1994)
- Renaud B, "Outcomes of primary and catheter-related bacteremia. A cohort and case-control study in critically ill patients", Am J Respir Crit Care Med, 163, pp.1584~1590 (2001)
- Marschall J, "Catheter-associated bloodstream infections: looking outside of the ICU", Am J Infect Control, 36, pp.S172~ (2008)
- Mermel LA, "Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America", Clin Infect Dis, 49, pp.1~45 (2009)
- Schrenzel J, "Clinical relevance of new diagnostic methods for bloodstream infections", Int J Antimicrob Agents, 30(1), pp.S2~S6 (2007)
- Sleigh J, "Detection of bacteraemia in critically ill patients using 16S rDNA polymerase chain reaction and DNA sequencing", Intensive Care Med, 27, pp.1269~1273 (2001)
- Lehmann LE, "A multiplex real-time PCR assay for rapid detection and differentiation of 25 bacterial and fungal pathogens from whole blood samples", Med Microbiol Immunol, 197, pp.313~324 (2008)
- 김백남, "혈액배양검사의 원리와 실제", Infection and Chemotherapy, 39(3), pp.111~116 (2007), 대한감염학회
- Murray PR, "The clinician and the microbiology laboratory, in Principles and practice of infectious diseases", pp.236~238 (2009), Churchill Livingstone
- Safdar N, "Meta-analysis: methods for diagnosing intravascular device-related bloodstream infection", Ann Intern Med, 142, pp.451~466 (2005)
- Raad I, "Differential time to positivity: a useful method for diagnosing catheter-related bloodstream infections", Ann Intern Med, 140, pp.18~25 (2004)
- Klaerner HG, "Failure of an automated blood culture system to detect nonfermentative gram-negative bacteria", J Clin Microbiol, 38, pp.1036~1041 (2000)